What are the options for treating PS ?

For many years surgery has been the only effective treatment for PS. But with the arrival on the scene of catheter-based therapy, it has today virtually taken-over the treatment of PS. Trans-Catheter Balloon dilatation is effective in most cases, and has lesser morbidity than surgery.

What is Balloon Pulmonary Valvotomy ?

Balloon Pulmonary Valvotomy - or BPV - is a catheter based treatment for PS. A "catheter" is a thin plastic tube that can be threaded through the arteries into the heart itself. The catheter is introduced through a small needle-stick in the groin or forearm and guided into the heart. In Pulmonary Stenosis the catheter is passed into the right atrium, then into the right ventricle across the tricuspid valve, and finally guided across the narrow pulmonary valve. The specially designed "balloon catheter" has a device similar to a balloon positioned at the tip of the catheter. This balloon is positioned just across the narrow pulmonary valve, and then inflated. The blown-up balloon "opens up" the narrow pulmonary valve, relieving the block ! Simple, isn't it ?

How effective is BPV ?

BPV has become a very effective treatment for PS, almost making surgery for PS obsolete. When the narrowing is only at the pulmonary valve, there is almost complete relief of stenosis. And it avoids the drawbacks of surgery - pain, a scar on the chest, long in-hospital stay, and higher cost. If however additional narrow areas are present either above or below the pulmonary valve, the results may not be quite as good. One of the dangers of BPV is that it may "tear" the pulmonary valve, and make it "leaky" - Pulmonary Regurgitation. This however is very rare. And even if it occurs, it does not cause much problem immediately because the pressures on the right side of the heart are very much lower than the left side.

What about surgery - Does it have a role at all ?